ICD-9-CM Official Guidelines for Coding and Reporting - Office of ...

External cause of injury codes (E-codes) may be assigned
while the acute fracture codes are still applicable.
See Section I.C.17.b.1 for coding of acute fractures.
3) Use the full range of E codes
Use the full range of E codes to completely describe the cause,
the intent and the place of occurrence, if applicable, for all
injuries, poisonings, and adverse effects of drugs.
4) Assign as many E codes as necessary
Assign as many E codes as necessary to fully explain each
cause. If only one E code can be recorded, assign the E code
most related to the principal diagnosis.
5) The selection of the appropriate E code
The selection of the appropriate E code is guided by the Index
to External Causes, which is located after the alphabetical
index to diseases and by Inclusion and Exclusion notes in the
Tabular List.
6) E code can never be a principal diagnosis
An E code can never be a principal (first listed) diagnosis.
7) External cause code(s) with systemic inflammatory
response syndrome (SIRS)
An external cause code is not appropriate with a code from
subcategory 995.9, unless the patient also has an injury,
poisoning, or adverse effect of drugs.
b. Place of Occurrence Guideline
Use an additional code from category E849 to indicate the Place of
Occurrence for injuries and poisonings. The Place of Occurrence
describes the place where the event occurred and not the patient’s
activity at the time of the event.
Do not use E849.9 if the place of occurrence is not stated.
c. Adverse Effects of Drugs, Medicinal and Biological
Substances Guidelines
1) Do not code directly from the Table of Drugs
Do not code directly from the Table of Drugs and Chemicals.
Always refer back to the Tabular List.
ICD-9-CM Official Guidelines for Coding and Reporting
Effective October 1, 2008
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